Rise of Asthma in China Sparks Renewed Debate about Pollution and Place

Given the recentheadlines, it probably surprises no one that China has 16 of the world’s worst pollution hot-spots within its borders, and the negative health effects are beginning to become a major public health threat. In fact, air pollution contributed to over 1.2 million deaths in China in 2010. China recently approved 10 anti-pollution measures in response to persistent public outcry and environmental damage, but these will most likely be implemented over the course of years, and public health risks remain problematic in the meantime.

There has been a dramatic increase in the incidence of asthma in China over the last 20 years, and estimates that the rates are up by as much as 40% over the last five years. Shockingly, prevalence in some cities is 11% and rising.

Asthma, a potentially fatal disease, is the leading cause of hospitalization among children and carries a significant burden to families and communities in China. Children with asthma have increased rates of school absenteeism, and higher medical costs can be a major cause of stress for families.

Dr. Qian Qian Sun, a pediatrician working at Shandong’s Binzhou Medical University Hospital, said in an interview that if her patient’s asthma attacks are linked with air pollution, they often try to move to an area away from factories. Other families may take more extreme measures, such as this one reported in China Weekly about a young mother who moved their son to three different cities before sending him to London to control his asthma. The mother, well educated and resourceful, found leaving China to be the only remedy for her son’s ailment.

The article set China’s social media abuzz, and Internet users lamented the sorry state of China’s air quality, but few people showed understanding of the signs and symptoms of asthma, which is sorely lacking in China, according to a recent study surveying 29 cities in China.

Most exposure to air pollution occurs indoors, and complete avoidance is challenging if not impossible. “The link between motor vehicle emissions and asthma is fairly strong”, says Dr. Charles Weschler, Adjunct Professor at the Environmental and Occupational Health Sciences Institute at Rutgers University and visiting Professor at Tsinghua University in Beijing. “Most of the exposure to motor vehicle emissions actually occurs indoors, since this is where Chinese urban residents spend most of their time (and outdoor-to-indoor transport of motor vehicle emissions is significant). Other indoor pollutants, of both outdoor and indoor origin, are anticipated to contribute to asthma attacks.”

Sometimes leaving high pollution areas completely may be the only way to limit the risks of an asthma attack. Professor Weschler is aware of numerous U.S. researchers who have had to stop going to China due to attacks. While some families and foreign researchers have the resources and information needed in order to send their child abroad and stay away from high pollution areas, the vast majority of families in Chinese cities do not have this ability.

“On days with high concentration of pollutants, limit activity outside and try to avoid activities that result in deep breathing,” Professor Weschler recommends. “Try to work and sleep in indoor environments that have filtered pollutants from indoor air. Keep windows closed on high pollution days to limit the outdoor-to-indoor transport of outdoor pollutants. Avoid the indoor use of cleaning products and so called “air fresheners” that emit organic chemicals. Avoid activities that results in chemicals being emitted into indoor air (e.g., painting, floor polishing). Do not light candles, incense or mosquito coils. Use an exhaust fan/hood while cooking. No indoor smoking.”

However, perhaps the most effective solution is still a physical one. Writer Nan Xiaoqi (@u-chi哈琪) tweeted on Sina Weibo, in response to the news about the mother who moved for her asthmatic son, “Send him abroad if you love him.”

Lua Wilkinson

Lua Wilkinson is a PhD student in Nutrition at Cornell University, where she studies digital social networks to promote maternal and child health globally. As a nutritionist and ethnographer, she researches migration, food systems, economics, technology and anything else that bridges the gap between nutrition and society. She tweets from @LuaWilkinson and maintains a website, www.luawilkinson.com.

I was one of those who had to leave China due to pollution (coal allergy) related asthma. After three increasingly serious episodes requiring hospitalization, my pulmonary doctor urged me to leave China. Took three months to get my lung capacity back to normal, but no nebulizer, steroids or inhalers for the last year left me with no regrets.

M

China has an air problem. People complain about the outdoor air pollution, but, because China doesn’t have a national smoke-free law, indoor air pollution is even worse! Have you ever tried to breath in a smokey restaurant, bar/club? I’d rather be outside with 400 pm2.5 than inside with 400 pm2.5 that’s full of secondhand smoke carcinogens.